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  </head>
  <body>
    <div style="margin: auto; width: 1000px">
      <h4>Water Source Survey Bangladesh (Full)</h4>
      <table class="table table-bordered table-condensed" style="height: 100%; width: 100%">
        <thead>
          <tr>
            <th style="width: 20%;" class="headerCell">
              <h6>Field</h6>
            </th>
            <th style="width: 60%;" class="headerCell">
              <h6>Question</h6>
            </th>
            <th style="width: 20%;" class="headerCell">
              <h6>Answer</h6>
            </th>
          </tr>
        </thead>
        <tbody>
          <tr class="gray entryRow">
            <td style="padding-left: 5px;" class="fieldCell">
              <span>welcome</span>
            </td>
            <td class="questionCell">Welcome to the CCLPG project survey! 
              <br/>Please fill in the village details and then locate the water sources that are used for drinking and/or cooking.
              <br/>
            </td>
            <td class="answerCell response-note-cell"/>
          </tr>
          <tr class="entryRow">
            <td style="padding-left: 5px;" class="fieldCell">
              <span>upazila
                <span class="required">(required)</span>
              </span>
            </td>
            <td class="questionCell">Upazila name</td>
            <td>
              <table class="table table-bordered table-condensed">
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">94</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>Shibganj</span>
                  </td>
                </tr>
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">85</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>Shajahanpur</span>
                  </td>
                </tr>
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">95</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>Sonatola</span>
                  </td>
                </tr>
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">30</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>Gobindaganj</span>
                  </td>
                </tr>
              </table>
            </td>
          </tr>
          <tr class="gray entryRow">
            <td style="padding-left: 5px;" class="fieldCell">
              <span>union
                <span class="required">(required)</span>
              </span>
            </td>
            <td class="questionCell">Union name</td>
            <td>
              <table class="table table-bordered table-condensed">
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">union_code</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>union_name::english</span>
                  </td>
                </tr>
              </table>
            </td>
          </tr>
          <tr class="entryRow">
            <td style="padding-left: 5px;" class="fieldCell">
              <span>village_first_letter
                <span class="required">(required)</span>
              </span>
            </td>
            <td class="questionCell">Select the first letter of the village name</td>
            <td>
              <table class="table table-bordered table-condensed">
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">vill_first_code</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>vill_first_name</span>
                  </td>
                </tr>
              </table>
            </td>
          </tr>
          <tr class="gray entryRow">
            <td style="padding-left: 5px;" class="fieldCell">
              <span>village
                <span class="required">(required)</span>
              </span>
            </td>
            <td class="questionCell">Village name</td>
            <td>
              <table class="table table-bordered table-condensed">
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">village_code</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>village_name::english</span>
                  </td>
                </tr>
              </table>
            </td>
          </tr>
          <tr class="entryRow">
            <td style="padding-left: 5px;" class="fieldCell">
              <span>cluster
                <span class="required">(required)</span>
              </span>
            </td>
            <td class="questionCell">Cluster Name</td>
            <td>
              <table class="table table-bordered table-condensed">
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">cluster_code</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>cluster_name::english</span>
                  </td>
                </tr>
              </table>
            </td>
          </tr>
          <tr class="gray entryRow">
            <td style="padding-left: 5px;" class="fieldCell">
              <span>enumerator_name
                <span class="required">(required)</span>
              </span>
            </td>
            <td class="questionCell">Enumerator name</td>
            <td>
              <table class="table table-bordered table-condensed">
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">enum_code</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>enum_name</span>
                  </td>
                </tr>
              </table>
            </td>
          </tr>
          <tr class="entryRow">
            <td style="padding-left: 5px;" class="fieldCell">
              <span>respondent_search</span>
            </td>
            <td class="questionCell">Interview the caretaker of the water source, if one exists and they can be located. If no caretaker exists, for example because the water source is a surface water source, or the caretaker cannot be located, then interview the nearby households. With respect to observations regarding the tubewell, use your own observations as well as the respondent's answers to give the correct responses. 
              <br/>Remember that we are interested only in water sources used for drinking and/or cooking!
              <br/>
            </td>
            <td class="answerCell response-note-cell"/>
          </tr>
          <tr class="gray entryRow">
            <td style="padding-left: 5px;" class="fieldCell">
              <span>introduction</span>
            </td>
            <td class="questionCell">We are working for an NGO called NGO Forum for Public Health, and collaborating with researchers from Stockholm University. We are working on a project in this region to provide access to safe drinking water. As you may know, your village is participating in this project. 3/4 of the villages that participate in this project will receive a project to provide safe drinking water.</td>
            <td class="answerCell response-note-cell"/>
          </tr>
          <tr class="entryRow">
            <td style="padding-left: 5px;" class="fieldCell">
              <span>data</span>
            </td>
            <td class="questionCell">As part of the project, we are collecting information about sources of drinking water used in the village. We want to ask you some questions about this source of drinking water. None of the information we are collecting in this survey is private, but no one who is not connected with the project will have access to your personal information, like your name. We will only use your personal information, like your name, in carrying out this project, and if we use information from the survey in the future we will remove your name and change the location of this water source so that no one can recognize you, or this water source. There are no other risks to participating in this project. 
              <br/>The questions should take less than fifteen minutes. You do not have to participate in the survey, you do not have to answer any question unless you want to, and you can stop answering questions at any time. Whether or not you participate in the survey does not affect whether or not this village will receive the project to provide safe drinking water. At the end of the survey, if you agree, we will take samples from the water to test for both arsenic and bacterial contamination. Hopefully the results of these tests will be helpful to you and others in deciding how to get safe water for your families. There are no costs involved to answering our questions, beyond the time it will take you to do so. However, answering the questions could help us and other NGOs to design better projects in the future to provide safe drinking water in villages like this one. 
              <br/>  
              <br/>If you have any other questions about this project, please contact Ahasan Habib at NGO Forum on 01917232200.
              <br/>
            </td>
            <td class="answerCell response-note-cell"/>
          </tr>
          <tr class="gray entryRow">
            <td style="padding-left: 5px;" class="fieldCell">
              <span>respondent_name
                <span class="required">(required)</span>
              </span>
            </td>
            <td class="questionCell">Respondent Name
              <p class="hint">Please insert the name and surname of the main respondent. Check spelling.</p>
            </td>
            <td class="answerCell response-note-cell"/>
          </tr>
          <tr class="entryRow">
            <td style="padding-left: 5px;" class="fieldCell">
              <span>consent_given
                <span class="required">(required)</span>
              </span>
            </td>
            <td class="questionCell">Does the respondent consent to proceed?
              <p class="hint">Remember, they do not have to necessarily answer to all the questions.</p>
            </td>
            <td>
              <table class="table table-bordered table-condensed">
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">yes</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>Yes</span>
                  </td>
                </tr>
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">no</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>No</span>
                  </td>
                </tr>
              </table>
            </td>
          </tr>
          <tr class="gray entryRow">
            <td style="padding-left: 5px;" class="fieldCell">
              <span>refuse_reason
                <span class="required">(required)</span>
              </span>
            </td>
            <td class="questionCell">Why does the respondent refuse to be interviewed?
              <p class="relevance">Question relevant when: selected( ${consent_given} , 'no')</p>
            </td>
            <td class="answerCell response-note-cell"/>
          </tr>
          <tr class="entryRow">
            <td style="padding-left: 5px;" class="fieldCell">
              <span>respondent_village_first_letter
                <span class="required">(required)</span>
              </span>
            </td>
            <td class="questionCell">Select the first letter of the village of the respondent.
              <p class="relevance">Question relevant when: selected( ${consent_given} , 'yes')</p>
            </td>
            <td>
              <table class="table table-bordered table-condensed">
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">vill_first_code</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>vill_first_name</span>
                  </td>
                </tr>
              </table>
            </td>
          </tr>
          <tr class="gray entryRow">
            <td style="padding-left: 5px;" class="fieldCell">
              <span>respondent_village
                <span class="required">(required)</span>
              </span>
            </td>
            <td class="questionCell">Please select the village of the respondent.</td>
            <td>
              <table class="table table-bordered table-condensed">
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">village_code</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>village_name::english</span>
                  </td>
                </tr>
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">999</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>The village is not on the list.</span>
                  </td>
                </tr>
              </table>
            </td>
          </tr>
          <tr class="entryRow">
            <td style="padding-left: 5px;" class="fieldCell">
              <span>respondent_cluster
                <span class="required">(required)</span>
              </span>
            </td>
            <td class="questionCell">Please select the cluster of the respondent.
              <p class="relevance">Question relevant when: selected( ${consent_given} , 'yes') and not(selected( ${respondent_village} , '999'))</p>
            </td>
            <td>
              <table class="table table-bordered table-condensed">
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">cluster_code</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>cluster_name::english</span>
                  </td>
                </tr>
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">999</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>The cluster is not on the list.</span>
                  </td>
                </tr>
              </table>
            </td>
          </tr>
          <tr class="gray entryRow">
            <td style="padding-left: 5px;" class="fieldCell">
              <span>respondent_cluster_check</span>
            </td>
            <td class="questionCell">Are you sure that the cluster of the respondent is different from the cluster where you are conducting the water source survey? If no, please go back and review your answers.
              <p class="relevance">Question relevant when: ${respondent_cluster} != ${cluster}</p>
            </td>
            <td class="answerCell response-note-cell"/>
          </tr>
          <tr class="entryRow">
            <td style="padding-left: 5px;" class="fieldCell">
              <span>respondent_hh_first_letter
                <span class="required">(required)</span>
              </span>
            </td>
            <td class="questionCell">What is the first letter of the name of the HEAD of your household?
              <p class="relevance">Question relevant when: selected( ${consent_given} , 'yes') and not(selected( ${respondent_village} , '999') or selected( ${respondent_cluster} , '999') )</p>
            </td>
            <td>
              <table class="table table-bordered table-condensed">
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">hh_first_code</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>hh_first_name</span>
                  </td>
                </tr>
              </table>
            </td>
          </tr>
          <tr class="gray entryRow">
            <td style="padding-left: 5px;" class="fieldCell">
              <span>responent_hh_head_num
                <span class="required">(required)</span>
              </span>
            </td>
            <td class="questionCell">What is the name of the HEAD of your household?
              <p class="relevance">Question relevant when: selected( ${consent_given} , 'yes') and not(selected( ${respondent_village} , '999') or selected( ${respondent_cluster} , '999') )</p>
            </td>
            <td>
              <table class="table table-bordered table-condensed">
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">hh_code</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>hh_label</span>
                  </td>
                </tr>
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">999</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>The household is not on the list.</span>
                  </td>
                </tr>
              </table>
            </td>
          </tr>
          <tr class="entryRow">
            <td style="padding-left: 5px;" class="fieldCell">
              <span>phone_number_note</span>
            </td>
            <td class="questionCell">We would like to ask for your phone number. The main reason is that one of the water tests we will do takes 1 or 2 days to complete, so we will need to send you a SMS with the results.
              <p class="relevance">Question relevant when: selected( ${consent_given} , 'yes')</p>
            </td>
            <td class="answerCell response-note-cell"/>
          </tr>
          <tr class="gray entryRow">
            <td style="padding-left: 5px;" class="fieldCell">
              <span>phone_number_yn
                <span class="required">(required)</span>
              </span>
            </td>
            <td class="questionCell">Are you happy to give your phone number?
              <p class="relevance">Question relevant when: selected( ${consent_given} , 'yes')</p>
            </td>
            <td>
              <table class="table table-bordered table-condensed">
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">yes</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>Yes</span>
                  </td>
                </tr>
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">no</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>No</span>
                  </td>
                </tr>
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">ra</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>Refused to answer</span>
                  </td>
                </tr>
              </table>
            </td>
          </tr>
          <tr class="entryRow">
            <td style="padding-left: 5px; background-color: #707070; color: #FFFFFF;" colspan="3">
              <span>Phone number.</span>
            </td>
          </tr>
          <tr class="gray entryRow">
            <td style="height: 100%;">
              <div style="height: 100%; width: 100%">
                <table class="table borderless" style="height: 100%">
                  <tr>
                    <td class="spacer" style="background-color: #707070;"/>
                    <td class="fieldCell" style="padding-left: 5px;">
                      <span>phone_number
                        <span class="required">(required)</span>
                      </span>
                    </td>
                  </tr>
                </table>
              </div>
            </td>
            <td class="questionCell">Mobile phone number of respondent.
              <p class="hint">Enter with no spaces.</p>
              <p class="relevance">Question relevant when: selected( ${phone_number_yn} , 'yes')</p>
              <p class="constraint">Response constrained to: regex(., '^[0-9]{11}$')</p>
            </td>
            <td class="answerCell response-note-cell"/>
          </tr>
          <tr class="entryRow">
            <td style="height: 100%;">
              <div style="height: 100%; width: 100%">
                <table class="table borderless" style="height: 100%">
                  <tr>
                    <td class="spacer" style="background-color: #707070;"/>
                    <td class="fieldCell" style="padding-left: 5px;">
                      <span>phone_number_check
                        <span class="required">(required)</span>
                      </span>
                    </td>
                  </tr>
                </table>
              </div>
            </td>
            <td class="questionCell">Please enter again the mobile phone number of respondent.
              <p class="hint">Enter with no spaces.</p>
              <p class="relevance">Question relevant when: selected( ${phone_number_yn} , 'yes')</p>
              <p class="constraint">Response constrained to: regex(., '^[0-9]{11}$')</p>
            </td>
            <td class="answerCell response-note-cell"/>
          </tr>
          <tr class="gray entryRow">
            <td style="padding-left: 5px;" class="fieldCell">
              <span>phone_numb_reenter
                <span class="required">(required)</span>
              </span>
            </td>
            <td class="questionCell">You entered two different numbers! 
              <br/>Please go back and check for mistakes.
              <br/>
              <p class="relevance">Question relevant when: ${phone_number} != ${phone_number_check}</p>
            </td>
            <td class="answerCell response-note-cell"/>
          </tr>
          <tr class="entryRow">
            <td style="padding-left: 5px;" class="fieldCell">
              <span>data_water_testing</span>
            </td>
            <td class="questionCell">As another part of the project, we are offering to test people's drinking water for arsenic and bacterial contamination. The test will inform you whether or not this water source is contaminated with arsenic and bacteria. If it is contaminated with arsenic or bacteria, then using it without treating it might make you or your children sick, or people from other households sick, if they also use the water source. May we test the water from this source?</td>
            <td class="answerCell response-note-cell"/>
          </tr>
          <tr class="gray entryRow">
            <td style="padding-left: 5px;" class="fieldCell">
              <span>testing_consent_given
                <span class="required">(required)</span>
              </span>
            </td>
            <td class="questionCell">Does the respondent consent to the water testing procedure?</td>
            <td>
              <table class="table table-bordered table-condensed">
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">yes</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>Yes</span>
                  </td>
                </tr>
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">no</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>No</span>
                  </td>
                </tr>
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">ra</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>Refused to answer</span>
                  </td>
                </tr>
              </table>
            </td>
          </tr>
          <tr class="entryRow">
            <td style="padding-left: 5px;" class="fieldCell">
              <span>bac_testing_instruction</span>
            </td>
            <td class="questionCell">Please collect the testing sample for the bacteria field test, for the arsenic field test and for the visual inspection of iron contamination.
              <p class="relevance">Question relevant when: selected( ${testing_consent_given} , 'yes')</p>
            </td>
            <td class="answerCell response-note-cell"/>
          </tr>
          <tr class="gray entryRow">
            <td style="padding-left: 5px;" class="fieldCell">
              <span>location_poss
                <span class="required">(required)</span>
              </span>
            </td>
            <td class="questionCell">Is it possible to collect GPS coordinates for water source?
              <p class="hint">Do not change this field unless it proves impossible to record GPS coordinates. If you have problems, go to settings/location/mode and choose “high accuracy”, then try again. Only change this field if you have first verified that it is impossible to collect GPS coordinates.</p>
              <p class="relevance">Question relevant when: selected( ${consent_given} , 'yes')</p>
            </td>
            <td>
              <table class="table table-bordered table-condensed">
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">yes</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>Yes</span>
                  </td>
                </tr>
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">no</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>No</span>
                  </td>
                </tr>
              </table>
            </td>
          </tr>
          <tr class="entryRow">
            <td style="padding-left: 5px; background-color: #707070; color: #FFFFFF;" colspan="3">
              <span>Latitude manual</span>
              <p class="relevance">Group relevant when: selected( ${location_poss} , 'no')</p>
            </td>
          </tr>
          <tr class="gray entryRow">
            <td style="height: 100%;">
              <div style="height: 100%; width: 100%">
                <table class="table borderless" style="height: 100%">
                  <tr>
                    <td class="spacer" style="background-color: #707070;"/>
                    <td class="fieldCell" style="padding-left: 5px;">
                      <span>latitude_dd
                        <span class="required">(required)</span>
                      </span>
                    </td>
                  </tr>
                </table>
              </div>
            </td>
            <td class="questionCell">LATITUDE, degrees:
              <p class="hint">Enter 2 digits with no spaces.</p>
              <p class="constraint">Response constrained to: regex(., '^[0-9]{2}$')</p>
            </td>
            <td class="answerCell response-note-cell"/>
          </tr>
          <tr class="entryRow">
            <td style="height: 100%;">
              <div style="height: 100%; width: 100%">
                <table class="table borderless" style="height: 100%">
                  <tr>
                    <td class="spacer" style="background-color: #707070;"/>
                    <td class="fieldCell" style="padding-left: 5px;">
                      <span>latitude_mm
                        <span class="required">(required)</span>
                      </span>
                    </td>
                  </tr>
                </table>
              </div>
            </td>
            <td class="questionCell">LATITUDE, minutes:
              <p class="hint">Enter 2 digits with no spaces.</p>
              <p class="constraint">Response constrained to: regex(., '^[0-9]{2}$')</p>
            </td>
            <td class="answerCell response-note-cell"/>
          </tr>
          <tr class="gray entryRow">
            <td style="height: 100%;">
              <div style="height: 100%; width: 100%">
                <table class="table borderless" style="height: 100%">
                  <tr>
                    <td class="spacer" style="background-color: #707070;"/>
                    <td class="fieldCell" style="padding-left: 5px;">
                      <span>latitude_ss
                        <span class="required">(required)</span>
                      </span>
                    </td>
                  </tr>
                </table>
              </div>
            </td>
            <td class="questionCell">LATITUDE, seconds:
              <p class="hint">Enter "ss.ss" with no spaces.</p>
            </td>
            <td class="answerCell response-note-cell"/>
          </tr>
          <tr class="entryRow">
            <td style="padding-left: 5px; background-color: #707070; color: #FFFFFF;" colspan="3">
              <span>Longitude manual</span>
              <p class="relevance">Group relevant when: selected( ${location_poss} , 'no')</p>
            </td>
          </tr>
          <tr class="gray entryRow">
            <td style="height: 100%;">
              <div style="height: 100%; width: 100%">
                <table class="table borderless" style="height: 100%">
                  <tr>
                    <td class="spacer" style="background-color: #707070;"/>
                    <td class="fieldCell" style="padding-left: 5px;">
                      <span>longitude_dd
                        <span class="required">(required)</span>
                      </span>
                    </td>
                  </tr>
                </table>
              </div>
            </td>
            <td class="questionCell">LONGITUDE, degrees:
              <p class="hint">Enter 3 digits with no spaces.</p>
              <p class="constraint">Response constrained to: regex(., '^[0-9]{3}$')</p>
            </td>
            <td class="answerCell response-note-cell"/>
          </tr>
          <tr class="entryRow">
            <td style="height: 100%;">
              <div style="height: 100%; width: 100%">
                <table class="table borderless" style="height: 100%">
                  <tr>
                    <td class="spacer" style="background-color: #707070;"/>
                    <td class="fieldCell" style="padding-left: 5px;">
                      <span>longitude_mm
                        <span class="required">(required)</span>
                      </span>
                    </td>
                  </tr>
                </table>
              </div>
            </td>
            <td class="questionCell">LONGITUDE, minutes:
              <p class="hint">Enter 2 digits with no spaces.</p>
              <p class="constraint">Response constrained to: regex(., '^[0-9]{2}$')</p>
            </td>
            <td class="answerCell response-note-cell"/>
          </tr>
          <tr class="gray entryRow">
            <td style="height: 100%;">
              <div style="height: 100%; width: 100%">
                <table class="table borderless" style="height: 100%">
                  <tr>
                    <td class="spacer" style="background-color: #707070;"/>
                    <td class="fieldCell" style="padding-left: 5px;">
                      <span>longitude_ss
                        <span class="required">(required)</span>
                      </span>
                    </td>
                  </tr>
                </table>
              </div>
            </td>
            <td class="questionCell">LONGITUDE, seconds:
              <p class="hint">Enter "ss.ss" with no spaces.</p>
            </td>
            <td class="answerCell response-note-cell"/>
          </tr>
          <tr class="entryRow">
            <td style="height: 100%;">
              <div style="height: 100%; width: 100%">
                <table class="table borderless" style="height: 100%">
                  <tr>
                    <td class="spacer" style="background-color: #707070;"/>
                    <td class="fieldCell" style="padding-left: 5px;">
                      <span>location_check
                        <span class="required">(required)</span>
                      </span>
                    </td>
                  </tr>
                </table>
              </div>
            </td>
            <td class="questionCell">Please take a photograph of the reading on the GPS.</td>
            <td class="answerCell response-note-cell"/>
          </tr>
          <tr class="gray entryRow">
            <td style="padding-left: 5px;" class="fieldCell">
              <span>location
                <span class="required">(required)</span>
              </span>
            </td>
            <td class="questionCell">Collect the coordinates of the water source.
              <p class="hint">Remember, you must be outside to collect GPS coordinates!</p>
              <p class="relevance">Question relevant when: selected( ${location_poss} ,'yes')</p>
            </td>
            <td class="answerCell response-note-cell"/>
          </tr>
          <tr class="entryRow">
            <td style="padding-left: 5px; background-color: #707070; color: #FFFFFF;" colspan="3">
              <span>Water source information</span>
              <p class="relevance">Group relevant when: selected( ${consent_given} , 'yes')</p>
            </td>
          </tr>
          <tr class="gray entryRow">
            <td style="height: 100%;">
              <div style="height: 100%; width: 100%">
                <table class="table borderless" style="height: 100%">
                  <tr>
                    <td class="spacer" style="background-color: #707070;"/>
                    <td class="fieldCell" style="padding-left: 5px;">
                      <span>water_source_pic
                        <span class="required">(required)</span>
                      </span>
                    </td>
                  </tr>
                </table>
              </div>
            </td>
            <td class="questionCell">Take a picture of the water source. 
              <br/>Please include in the picture also the surrounding area
              <br/>
            </td>
            <td class="answerCell response-note-cell"/>
          </tr>
          <tr class="entryRow">
            <td style="height: 100%;">
              <div style="height: 100%; width: 100%">
                <table class="table borderless" style="height: 100%">
                  <tr>
                    <td class="spacer" style="background-color: #707070;"/>
                    <td class="fieldCell" style="padding-left: 5px;">
                      <span>water_source_id
                        <span class="required">(required)</span>
                      </span>
                    </td>
                  </tr>
                </table>
              </div>
            </td>
            <td class="questionCell">Describe the source using local identifiers e.g. nearby households; the way in which local people refer to the source.</td>
            <td class="answerCell response-note-cell"/>
          </tr>
          <tr class="gray entryRow">
            <td style="height: 100%;">
              <div style="height: 100%; width: 100%">
                <table class="table borderless" style="height: 100%">
                  <tr>
                    <td class="spacer" style="background-color: #707070;"/>
                    <td class="fieldCell" style="padding-left: 5px;">
                      <span>water_source_type
                        <span class="required">(required)</span>
                      </span>
                    </td>
                  </tr>
                </table>
              </div>
            </td>
            <td class="questionCell">What type of source is it?</td>
            <td>
              <table class="table table-bordered table-condensed">
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">piped</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>Tap (piped water)</span>
                  </td>
                </tr>
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">tubewell</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>Tubewell</span>
                  </td>
                </tr>
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">airp</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>Arsenic Iron Removal Plant (AIRP)</span>
                  </td>
                </tr>
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">psf</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>Pond Sand Filter (PSF)</span>
                  </td>
                </tr>
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">dug_well</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>Dug well</span>
                  </td>
                </tr>
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">surface_water</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>Surface water (river, stream, dam, lake, pond, canal, irrigation channel)</span>
                  </td>
                </tr>
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">other</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>Other</span>
                  </td>
                </tr>
              </table>
            </td>
          </tr>
          <tr class="entryRow">
            <td style="height: 100%;">
              <div style="height: 100%; width: 100%">
                <table class="table borderless" style="height: 100%">
                  <tr>
                    <td class="spacer" style="background-color: #707070;"/>
                    <td class="fieldCell" style="padding-left: 5px;">
                      <span>water_source_type_other
                        <span class="required">(required)</span>
                      </span>
                    </td>
                  </tr>
                </table>
              </div>
            </td>
            <td class="questionCell">Please specify other.
              <p class="relevance">Question relevant when: selected( ${water_source_type} , 'other')</p>
            </td>
            <td class="answerCell response-note-cell"/>
          </tr>
          <tr class="gray entryRow">
            <td style="height: 100%;">
              <div style="height: 100%; width: 100%">
                <table class="table borderless" style="height: 100%">
                  <tr>
                    <td class="spacer" style="background-color: #707070;"/>
                    <td class="fieldCell" style="padding-left: 5px;">
                      <span>water_source_owntype
                        <span class="required">(required)</span>
                      </span>
                    </td>
                  </tr>
                </table>
              </div>
            </td>
            <td class="questionCell">Who owns this water source?
              <p class="relevance">Question relevant when: not(selected( ${water_source_type} , 'surface_water') )</p>
            </td>
            <td>
              <table class="table table-bordered table-condensed">
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">private</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>A private household</span>
                  </td>
                </tr>
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">communal</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>It is a communal/public source</span>
                  </td>
                </tr>
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">other</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>Other</span>
                  </td>
                </tr>
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">dk</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>Don't know</span>
                  </td>
                </tr>
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">ra</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>Refused to answer</span>
                  </td>
                </tr>
              </table>
            </td>
          </tr>
          <tr class="entryRow">
            <td style="height: 100%;">
              <div style="height: 100%; width: 100%">
                <table class="table borderless" style="height: 100%">
                  <tr>
                    <td class="spacer" style="background-color: #707070;"/>
                    <td class="fieldCell" style="padding-left: 5px;">
                      <span>water_source_owntype_other
                        <span class="required">(required)</span>
                      </span>
                    </td>
                  </tr>
                </table>
              </div>
            </td>
            <td class="questionCell">Please specify other.
              <p class="relevance">Question relevant when: selected( ${water_source_owntype} , 'other')</p>
            </td>
            <td class="answerCell response-note-cell"/>
          </tr>
          <tr class="gray entryRow">
            <td style="height: 100%;">
              <div style="height: 100%; width: 100%">
                <table class="table borderless" style="height: 100%">
                  <tr>
                    <td class="spacer" style="background-color: #707070;"/>
                    <td class="fieldCell" style="padding-left: 5px;">
                      <span>owner_first_letter
                        <span class="required">(required)</span>
                      </span>
                    </td>
                  </tr>
                </table>
              </div>
            </td>
            <td class="questionCell">What is the first letter of the name of the HEAD of the household that owns this water source?
              <p class="relevance">Question relevant when: selected( ${water_source_owntype} , 'private')</p>
            </td>
            <td>
              <table class="table table-bordered table-condensed">
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">hh_first_code</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>hh_first_name</span>
                  </td>
                </tr>
              </table>
            </td>
          </tr>
          <tr class="entryRow">
            <td style="height: 100%;">
              <div style="height: 100%; width: 100%">
                <table class="table borderless" style="height: 100%">
                  <tr>
                    <td class="spacer" style="background-color: #707070;"/>
                    <td class="fieldCell" style="padding-left: 5px;">
                      <span>owner_h_head_num
                        <span class="required">(required)</span>
                      </span>
                    </td>
                  </tr>
                </table>
              </div>
            </td>
            <td class="questionCell">What is the name of the HEAD of the household that owns this water source?
              <p class="relevance">Question relevant when: selected( ${water_source_owntype} , 'private')</p>
            </td>
            <td>
              <table class="table table-bordered table-condensed">
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">hh_code</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>hh_label</span>
                  </td>
                </tr>
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">999</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>The household is not on the list.</span>
                  </td>
                </tr>
              </table>
            </td>
          </tr>
          <tr class="gray entryRow">
            <td style="height: 100%;">
              <div style="height: 100%; width: 100%">
                <table class="table borderless" style="height: 100%">
                  <tr>
                    <td class="spacer" style="background-color: #707070;"/>
                    <td class="fieldCell" style="padding-left: 5px;">
                      <span>owner_h_head_other
                        <span class="required">(required)</span>
                      </span>
                    </td>
                  </tr>
                </table>
              </div>
            </td>
            <td class="questionCell">Please write the name of the household head of the household that owns this water source.
              <p class="hint">Please only use this option after checking carefully that the name of the household head of the household that owns this water source does not appear on the list. Check for possible spelling variations, or check whether a different household head is listed e.g. because a previous household head has become elderly or passed away.</p>
              <p class="relevance">Question relevant when: selected( ${owner_h_head_num} ,'999')</p>
            </td>
            <td class="answerCell response-note-cell"/>
          </tr>
          <tr class="entryRow">
            <td style="height: 100%;">
              <div style="height: 100%; width: 100%">
                <table class="table borderless" style="height: 100%">
                  <tr>
                    <td class="spacer" style="background-color: #707070;"/>
                    <td class="fieldCell" style="padding-left: 5px;">
                      <span>caretaker
                        <span class="required">(required)</span>
                      </span>
                    </td>
                  </tr>
                </table>
              </div>
            </td>
            <td class="questionCell">Is the respondent the caretaker of the water source?
              <p class="relevance">Question relevant when: not(selected( ${water_source_type} , 'surface_water') )</p>
            </td>
            <td>
              <table class="table table-bordered table-condensed">
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">yes</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>Yes</span>
                  </td>
                </tr>
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">no</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>No</span>
                  </td>
                </tr>
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">ra</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>Refused to answer</span>
                  </td>
                </tr>
              </table>
            </td>
          </tr>
          <tr class="gray entryRow">
            <td style="height: 100%;">
              <div style="height: 100%; width: 100%">
                <table class="table borderless" style="height: 100%">
                  <tr>
                    <td class="spacer" style="background-color: #707070;"/>
                    <td class="fieldCell" style="padding-left: 5px;">
                      <span>caretaker_yn
                        <span class="required">(required)</span>
                      </span>
                    </td>
                  </tr>
                </table>
              </div>
            </td>
            <td class="questionCell">Does the source have a caretaker?
              <p class="relevance">Question relevant when: selected( ${caretaker} ,'no')</p>
            </td>
            <td>
              <table class="table table-bordered table-condensed">
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">yes</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>Yes</span>
                  </td>
                </tr>
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">no</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>No</span>
                  </td>
                </tr>
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">ra</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>Refused to answer</span>
                  </td>
                </tr>
              </table>
            </td>
          </tr>
          <tr class="entryRow">
            <td style="height: 100%;">
              <div style="height: 100%; width: 100%">
                <table class="table borderless" style="height: 100%">
                  <tr>
                    <td class="spacer" style="background-color: #707070;"/>
                    <td class="fieldCell" style="padding-left: 5px;">
                      <span>caretaker_nme
                        <span class="required">(required)</span>
                      </span>
                    </td>
                  </tr>
                </table>
              </div>
            </td>
            <td class="questionCell">Who is the caretaker of this source?
              <p class="relevance">Question relevant when: selected( ${caretaker_yn} ,'yes')</p>
            </td>
            <td class="answerCell response-note-cell"/>
          </tr>
          <tr class="gray entryRow">
            <td style="height: 100%;">
              <div style="height: 100%; width: 100%">
                <table class="table borderless" style="height: 100%">
                  <tr>
                    <td class="spacer" style="background-color: #707070;"/>
                    <td class="fieldCell" style="padding-left: 5px;">
                      <span>caretaker_number_yn
                        <span class="required">(required)</span>
                      </span>
                    </td>
                  </tr>
                </table>
              </div>
            </td>
            <td class="questionCell">Do you know [caretaker_name]'s cellphone number?
              <p class="relevance">Question relevant when: selected( ${caretaker_yn} ,'yes')</p>
            </td>
            <td>
              <table class="table table-bordered table-condensed">
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">yes</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>Yes</span>
                  </td>
                </tr>
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">no</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>No</span>
                  </td>
                </tr>
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">ra</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>Refused to answer</span>
                  </td>
                </tr>
              </table>
            </td>
          </tr>
          <tr class="entryRow">
            <td style="height: 100%;" colspan="3">
              <div style="height: 100%; width: 100%">
                <table class="table borderless" style="height: 100%">
                  <tr>
                    <td class="spacer" style="background-color: #707070;"/>
                    <td style="padding-left: 5px; background-color: #8C8C8C; color: #FFFFFF;">
                      <span>Water source information &gt; Phone number.</span>
                    </td>
                  </tr>
                </table>
              </div>
            </td>
          </tr>
          <tr class="gray entryRow">
            <td style="height: 100%;">
              <div style="height: 100%; width: 100%">
                <table class="table borderless" style="height: 100%">
                  <tr>
                    <td class="spacer" style="background-color: #707070;"/>
                    <td class="spacer" style="background-color: #8C8C8C;"/>
                    <td class="fieldCell" style="padding-left: 5px;">
                      <span>caretaker_phone_number
                        <span class="required">(required)</span>
                      </span>
                    </td>
                  </tr>
                </table>
              </div>
            </td>
            <td class="questionCell">Mobile phone number of caretaker.
              <p class="hint">Enter with no spaces.</p>
              <p class="relevance">Question relevant when: selected( ${caretaker_number_yn} , 'yes')</p>
              <p class="constraint">Response constrained to: regex(., '^[0-9]{11}$')</p>
            </td>
            <td class="answerCell response-note-cell"/>
          </tr>
          <tr class="entryRow">
            <td style="height: 100%;">
              <div style="height: 100%; width: 100%">
                <table class="table borderless" style="height: 100%">
                  <tr>
                    <td class="spacer" style="background-color: #707070;"/>
                    <td class="spacer" style="background-color: #8C8C8C;"/>
                    <td class="fieldCell" style="padding-left: 5px;">
                      <span>caretaker_phone_number_check
                        <span class="required">(required)</span>
                      </span>
                    </td>
                  </tr>
                </table>
              </div>
            </td>
            <td class="questionCell">Please enter again the mobile phone number of respondent.
              <p class="hint">Enter with no spaces.</p>
              <p class="relevance">Question relevant when: selected( ${caretaker_number_yn} , 'yes')</p>
              <p class="constraint">Response constrained to: regex(., '^[0-9]{11}$')</p>
            </td>
            <td class="answerCell response-note-cell"/>
          </tr>
          <tr class="gray entryRow">
            <td style="height: 100%;">
              <div style="height: 100%; width: 100%">
                <table class="table borderless" style="height: 100%">
                  <tr>
                    <td class="spacer" style="background-color: #707070;"/>
                    <td class="fieldCell" style="padding-left: 5px;">
                      <span>caretaker_phone_reenter
                        <span class="required">(required)</span>
                      </span>
                    </td>
                  </tr>
                </table>
              </div>
            </td>
            <td class="questionCell">You entered two different numbers! 
              <br/>Please go back and check for mistakes.
              <br/>
              <p class="relevance">Question relevant when: ${caretaker_phone_number} != ${caretaker_phone_number_check}</p>
            </td>
            <td class="answerCell response-note-cell"/>
          </tr>
          <tr class="entryRow">
            <td style="height: 100%;">
              <div style="height: 100%; width: 100%">
                <table class="table borderless" style="height: 100%">
                  <tr>
                    <td class="spacer" style="background-color: #707070;"/>
                    <td class="fieldCell" style="padding-left: 5px;">
                      <span>water_source_year_know
                        <span class="required">(required)</span>
                      </span>
                    </td>
                  </tr>
                </table>
              </div>
            </td>
            <td class="questionCell">Do you know the year this water source was installed?
              <p class="relevance">Question relevant when: not(selected( ${water_source_type} , 'surface_water') )</p>
            </td>
            <td>
              <table class="table table-bordered table-condensed">
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">yes</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>Yes</span>
                  </td>
                </tr>
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">no</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>No</span>
                  </td>
                </tr>
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">ra</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>Refused to answer</span>
                  </td>
                </tr>
              </table>
            </td>
          </tr>
          <tr class="gray entryRow">
            <td style="height: 100%;">
              <div style="height: 100%; width: 100%">
                <table class="table borderless" style="height: 100%">
                  <tr>
                    <td class="spacer" style="background-color: #707070;"/>
                    <td class="fieldCell" style="padding-left: 5px;">
                      <span>water_source_year
                        <span class="required">(required)</span>
                      </span>
                    </td>
                  </tr>
                </table>
              </div>
            </td>
            <td class="questionCell">Year of installation
              <p class="hint">Please provide an estimate.</p>
              <p class="relevance">Question relevant when: selected( ${water_source_year_know} , 'yes')</p>
              <p class="constraint">Response constrained to: regex(., '^[0-9]{4}$')</p>
            </td>
            <td class="answerCell response-note-cell"/>
          </tr>
          <tr class="entryRow">
            <td style="padding-left: 5px; background-color: #707070; color: #FFFFFF;" colspan="3">
              <span>Tubewell Questions</span>
              <p class="relevance">Group relevant when: selected( ${water_source_type} , 'tubewell')</p>
            </td>
          </tr>
          <tr class="gray entryRow">
            <td style="height: 100%;">
              <div style="height: 100%; width: 100%">
                <table class="table borderless" style="height: 100%">
                  <tr>
                    <td class="spacer" style="background-color: #707070;"/>
                    <td class="fieldCell" style="padding-left: 5px;">
                      <span>tubewell_type
                        <span class="required">(required)</span>
                      </span>
                    </td>
                  </tr>
                </table>
              </div>
            </td>
            <td class="questionCell">What type of tubewell is this?</td>
            <td>
              <table class="table table-bordered table-condensed">
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">STW</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>Shallow tubewell</span>
                  </td>
                </tr>
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">DTW</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>Deep tubewell</span>
                  </td>
                </tr>
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">DSTW</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>Deepset tubewell</span>
                  </td>
                </tr>
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">dk</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>Don't know</span>
                  </td>
                </tr>
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">ra</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>Refused to answer</span>
                  </td>
                </tr>
              </table>
            </td>
          </tr>
          <tr class="entryRow">
            <td style="height: 100%;">
              <div style="height: 100%; width: 100%">
                <table class="table borderless" style="height: 100%">
                  <tr>
                    <td class="spacer" style="background-color: #707070;"/>
                    <td class="fieldCell" style="padding-left: 5px;">
                      <span>water_source_depth_know
                        <span class="required">(required)</span>
                      </span>
                    </td>
                  </tr>
                </table>
              </div>
            </td>
            <td class="questionCell">Do you know the depth of this tubewell?</td>
            <td>
              <table class="table table-bordered table-condensed">
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">yes</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>Yes</span>
                  </td>
                </tr>
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">no</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>No</span>
                  </td>
                </tr>
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">ra</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>Refused to answer</span>
                  </td>
                </tr>
              </table>
            </td>
          </tr>
          <tr class="gray entryRow">
            <td style="height: 100%;">
              <div style="height: 100%; width: 100%">
                <table class="table borderless" style="height: 100%">
                  <tr>
                    <td class="spacer" style="background-color: #707070;"/>
                    <td class="fieldCell" style="padding-left: 5px;">
                      <span>water_source_depth
                        <span class="required">(required)</span>
                      </span>
                    </td>
                  </tr>
                </table>
              </div>
            </td>
            <td class="questionCell">Depth of well in feet.
              <p class="hint">Please provide an estimate.</p>
              <p class="relevance">Question relevant when: selected( ${water_source_depth_know} , 'yes')</p>
              <p class="constraint">Response constrained to: . &lt; 1000</p>
            </td>
            <td class="answerCell response-note-cell"/>
          </tr>
          <tr class="entryRow">
            <td style="height: 100%;">
              <div style="height: 100%; width: 100%">
                <table class="table borderless" style="height: 100%">
                  <tr>
                    <td class="spacer" style="background-color: #707070;"/>
                    <td class="fieldCell" style="padding-left: 5px;">
                      <span>water_source_tested
                        <span class="required">(required)</span>
                      </span>
                    </td>
                  </tr>
                </table>
              </div>
            </td>
            <td class="questionCell">Has this tubewell been tested for arsenic safety?</td>
            <td>
              <table class="table table-bordered table-condensed">
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">yes</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>Yes</span>
                  </td>
                </tr>
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">no</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>No</span>
                  </td>
                </tr>
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">dk</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>Don't know</span>
                  </td>
                </tr>
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">ra</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>Refused to answer</span>
                  </td>
                </tr>
              </table>
            </td>
          </tr>
          <tr class="gray entryRow">
            <td style="height: 100%;">
              <div style="height: 100%; width: 100%">
                <table class="table borderless" style="height: 100%">
                  <tr>
                    <td class="spacer" style="background-color: #707070;"/>
                    <td class="fieldCell" style="padding-left: 5px;">
                      <span>water_source_test_result
                        <span class="required">(required)</span>
                      </span>
                    </td>
                  </tr>
                </table>
              </div>
            </td>
            <td class="questionCell">Did the tests show that the well was arsenic safe?
              <p class="relevance">Question relevant when: selected( ${water_source_tested} , 'yes')</p>
            </td>
            <td>
              <table class="table table-bordered table-condensed">
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">yes</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>Yes</span>
                  </td>
                </tr>
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">no</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>No</span>
                  </td>
                </tr>
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">dk</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>Don't know</span>
                  </td>
                </tr>
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">ra</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>Refused to answer</span>
                  </td>
                </tr>
              </table>
            </td>
          </tr>
          <tr class="entryRow">
            <td style="height: 100%;">
              <div style="height: 100%; width: 100%">
                <table class="table borderless" style="height: 100%">
                  <tr>
                    <td class="spacer" style="background-color: #707070;"/>
                    <td class="fieldCell" style="padding-left: 5px;">
                      <span>water_source_color
                        <span class="required">(required)</span>
                      </span>
                    </td>
                  </tr>
                </table>
              </div>
            </td>
            <td class="questionCell">Is the tubewell marked with the color red or green?</td>
            <td>
              <table class="table table-bordered table-condensed">
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">red</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>Red</span>
                  </td>
                </tr>
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">green</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>Green</span>
                  </td>
                </tr>
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">not_marked</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>Not marked</span>
                  </td>
                </tr>
              </table>
            </td>
          </tr>
          <tr class="gray entryRow">
            <td style="height: 100%;">
              <div style="height: 100%; width: 100%">
                <table class="table borderless" style="height: 100%">
                  <tr>
                    <td class="spacer" style="background-color: #707070;"/>
                    <td class="fieldCell" style="padding-left: 5px;">
                      <span>tubewell_diag1
                        <span class="required">(required)</span>
                      </span>
                    </td>
                  </tr>
                </table>
              </div>
            </td>
            <td class="questionCell">Is there a latrine within 10m of the TW?</td>
            <td>
              <table class="table table-bordered table-condensed">
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">yes</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>Yes</span>
                  </td>
                </tr>
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">no</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>No</span>
                  </td>
                </tr>
              </table>
            </td>
          </tr>
          <tr class="entryRow">
            <td style="height: 100%;">
              <div style="height: 100%; width: 100%">
                <table class="table borderless" style="height: 100%">
                  <tr>
                    <td class="spacer" style="background-color: #707070;"/>
                    <td class="fieldCell" style="padding-left: 5px;">
                      <span>tubewell_diag2
                        <span class="required">(required)</span>
                      </span>
                    </td>
                  </tr>
                </table>
              </div>
            </td>
            <td class="questionCell">Are there any other sources of fecal pollution within 10m of TW?
              <p class="hint">Sources of fecal pollution include: waste material of cow dung or any other poultry or household waste or even clinical waste, kacha drainage system will be considered as source of fecal pollution.</p>
            </td>
            <td>
              <table class="table table-bordered table-condensed">
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">yes</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>Yes</span>
                  </td>
                </tr>
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">no</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>No</span>
                  </td>
                </tr>
              </table>
            </td>
          </tr>
          <tr class="gray entryRow">
            <td style="height: 100%;">
              <div style="height: 100%; width: 100%">
                <table class="table borderless" style="height: 100%">
                  <tr>
                    <td class="spacer" style="background-color: #707070;"/>
                    <td class="fieldCell" style="padding-left: 5px;">
                      <span>tubewell_diag3
                        <span class="required">(required)</span>
                      </span>
                    </td>
                  </tr>
                </table>
              </div>
            </td>
            <td class="questionCell">Is the nearest source of fecal pollution on higher ground than the TW?
              <p class="hint">Sources of fecal pollution include: waste material of cow dung or any other poultry or household waste or even clinical waste, kacha drainage system will be considered as source of fecal pollution.</p>
            </td>
            <td>
              <table class="table table-bordered table-condensed">
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">yes</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>Yes</span>
                  </td>
                </tr>
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">no</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>No</span>
                  </td>
                </tr>
              </table>
            </td>
          </tr>
          <tr class="entryRow">
            <td style="height: 100%;">
              <div style="height: 100%; width: 100%">
                <table class="table borderless" style="height: 100%">
                  <tr>
                    <td class="spacer" style="background-color: #707070;"/>
                    <td class="fieldCell" style="padding-left: 5px;">
                      <span>tubewell_diag4
                        <span class="required">(required)</span>
                      </span>
                    </td>
                  </tr>
                </table>
              </div>
            </td>
            <td class="questionCell">Is there any water logging around 2m of the TW?</td>
            <td>
              <table class="table table-bordered table-condensed">
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">yes</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>Yes</span>
                  </td>
                </tr>
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">no</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>No</span>
                  </td>
                </tr>
              </table>
            </td>
          </tr>
          <tr class="gray entryRow">
            <td style="height: 100%;">
              <div style="height: 100%; width: 100%">
                <table class="table borderless" style="height: 100%">
                  <tr>
                    <td class="spacer" style="background-color: #707070;"/>
                    <td class="fieldCell" style="padding-left: 5px;">
                      <span>platform
                        <span class="required">(required)</span>
                      </span>
                    </td>
                  </tr>
                </table>
              </div>
            </td>
            <td class="questionCell">Is there any platform of the tubewell?</td>
            <td>
              <table class="table table-bordered table-condensed">
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">yes</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>Yes</span>
                  </td>
                </tr>
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">no</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>No</span>
                  </td>
                </tr>
              </table>
            </td>
          </tr>
          <tr class="entryRow">
            <td style="height: 100%;">
              <div style="height: 100%; width: 100%">
                <table class="table borderless" style="height: 100%">
                  <tr>
                    <td class="spacer" style="background-color: #707070;"/>
                    <td class="fieldCell" style="padding-left: 5px;">
                      <span>tubewell_diag5
                        <span class="required">(required)</span>
                      </span>
                    </td>
                  </tr>
                </table>
              </div>
            </td>
            <td class="questionCell">Is the length of drainage less than 2m?
              <p class="relevance">Question relevant when: selected( ${platform} , 'yes')</p>
            </td>
            <td>
              <table class="table table-bordered table-condensed">
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">yes</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>Yes</span>
                  </td>
                </tr>
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">no</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>No</span>
                  </td>
                </tr>
              </table>
            </td>
          </tr>
          <tr class="gray entryRow">
            <td style="height: 100%;">
              <div style="height: 100%; width: 100%">
                <table class="table borderless" style="height: 100%">
                  <tr>
                    <td class="spacer" style="background-color: #707070;"/>
                    <td class="fieldCell" style="padding-left: 5px;">
                      <span>tubewell_diag6
                        <span class="required">(required)</span>
                      </span>
                    </td>
                  </tr>
                </table>
              </div>
            </td>
            <td class="questionCell">Is the drainage channel cracked, broken or need cleaning?
              <p class="relevance">Question relevant when: selected( ${platform} , 'yes')</p>
            </td>
            <td>
              <table class="table table-bordered table-condensed">
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">yes</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>Yes</span>
                  </td>
                </tr>
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">no</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>No</span>
                  </td>
                </tr>
              </table>
            </td>
          </tr>
          <tr class="entryRow">
            <td style="height: 100%;">
              <div style="height: 100%; width: 100%">
                <table class="table borderless" style="height: 100%">
                  <tr>
                    <td class="spacer" style="background-color: #707070;"/>
                    <td class="fieldCell" style="padding-left: 5px;">
                      <span>tubewell_diag7
                        <span class="required">(required)</span>
                      </span>
                    </td>
                  </tr>
                </table>
              </div>
            </td>
            <td class="questionCell">Is the platform less than 1m in width?
              <p class="relevance">Question relevant when: selected( ${platform} , 'yes')</p>
            </td>
            <td>
              <table class="table table-bordered table-condensed">
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">yes</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>Yes</span>
                  </td>
                </tr>
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">no</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>No</span>
                  </td>
                </tr>
              </table>
            </td>
          </tr>
          <tr class="gray entryRow">
            <td style="height: 100%;">
              <div style="height: 100%; width: 100%">
                <table class="table borderless" style="height: 100%">
                  <tr>
                    <td class="spacer" style="background-color: #707070;"/>
                    <td class="fieldCell" style="padding-left: 5px;">
                      <span>tubewell_diag8
                        <span class="required">(required)</span>
                      </span>
                    </td>
                  </tr>
                </table>
              </div>
            </td>
            <td class="questionCell">Is there any water logging within the platform area?
              <p class="relevance">Question relevant when: selected( ${platform} , 'yes')</p>
            </td>
            <td>
              <table class="table table-bordered table-condensed">
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">yes</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>Yes</span>
                  </td>
                </tr>
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">no</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>No</span>
                  </td>
                </tr>
              </table>
            </td>
          </tr>
          <tr class="entryRow">
            <td style="height: 100%;">
              <div style="height: 100%; width: 100%">
                <table class="table borderless" style="height: 100%">
                  <tr>
                    <td class="spacer" style="background-color: #707070;"/>
                    <td class="fieldCell" style="padding-left: 5px;">
                      <span>tubewell_diag9
                        <span class="required">(required)</span>
                      </span>
                    </td>
                  </tr>
                </table>
              </div>
            </td>
            <td class="questionCell">Is the platform cracked or broken?
              <p class="relevance">Question relevant when: selected( ${platform} , 'yes')</p>
            </td>
            <td>
              <table class="table table-bordered table-condensed">
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">yes</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>Yes</span>
                  </td>
                </tr>
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">no</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>No</span>
                  </td>
                </tr>
              </table>
            </td>
          </tr>
          <tr class="gray entryRow">
            <td style="height: 100%;">
              <div style="height: 100%; width: 100%">
                <table class="table borderless" style="height: 100%">
                  <tr>
                    <td class="spacer" style="background-color: #707070;"/>
                    <td class="fieldCell" style="padding-left: 5px;">
                      <span>tubewell_diag10
                        <span class="required">(required)</span>
                      </span>
                    </td>
                  </tr>
                </table>
              </div>
            </td>
            <td class="questionCell">Is the hand pump loose at the point of attachment to apron?</td>
            <td>
              <table class="table table-bordered table-condensed">
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">yes</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>Yes</span>
                  </td>
                </tr>
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">no</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>No</span>
                  </td>
                </tr>
              </table>
            </td>
          </tr>
          <tr class="entryRow">
            <td style="padding-left: 5px; background-color: #707070; color: #FFFFFF;" colspan="3">
              <span>Test Results</span>
            </td>
          </tr>
          <tr class="gray entryRow">
            <td style="height: 100%;">
              <div style="height: 100%; width: 100%">
                <table class="table borderless" style="height: 100%">
                  <tr>
                    <td class="spacer" style="background-color: #707070;"/>
                    <td class="fieldCell" style="padding-left: 5px;">
                      <span>ws_iron_test_result
                        <span class="required">(required)</span>
                      </span>
                    </td>
                  </tr>
                </table>
              </div>
            </td>
            <td class="questionCell">Is the water iron contaminated?
              <p class="hint">Select yes if the colour of the water is orange/red. Select no otherwise.</p>
              <p class="relevance">Question relevant when: selected( ${testing_consent_given} , 'yes')</p>
            </td>
            <td>
              <table class="table table-bordered table-condensed">
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">yes</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>Yes</span>
                  </td>
                </tr>
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">no</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>No</span>
                  </td>
                </tr>
              </table>
            </td>
          </tr>
          <tr class="entryRow">
            <td style="height: 100%;">
              <div style="height: 100%; width: 100%">
                <table class="table borderless" style="height: 100%">
                  <tr>
                    <td class="spacer" style="background-color: #707070;"/>
                    <td class="fieldCell" style="padding-left: 5px;">
                      <span>bac_testing_instruction</span>
                    </td>
                  </tr>
                </table>
              </div>
            </td>
            <td class="questionCell">Write the date and time on the label of the bottle for the bacteria test sample.
              <p class="relevance">Question relevant when: selected( ${testing_consent_given} , 'yes')</p>
            </td>
            <td class="answerCell response-note-cell"/>
          </tr>
          <tr class="gray entryRow">
            <td style="height: 100%;">
              <div style="height: 100%; width: 100%">
                <table class="table borderless" style="height: 100%">
                  <tr>
                    <td class="spacer" style="background-color: #707070;"/>
                    <td class="fieldCell" style="padding-left: 5px;">
                      <span>ws_bac_test_id_manual
                        <span class="required">(required)</span>
                      </span>
                    </td>
                  </tr>
                </table>
              </div>
            </td>
            <td class="questionCell">Please enter the id on the barcode for the bacteria field test
              <p class="relevance">Question relevant when: selected( ${testing_consent_given} , 'yes')</p>
            </td>
            <td class="answerCell response-note-cell"/>
          </tr>
          <tr class="entryRow">
            <td style="height: 100%;">
              <div style="height: 100%; width: 100%">
                <table class="table borderless" style="height: 100%">
                  <tr>
                    <td class="spacer" style="background-color: #707070;"/>
                    <td class="fieldCell" style="padding-left: 5px;">
                      <span>bac_test_id_temp
                        <span class="required">(required)</span>
                      </span>
                    </td>
                  </tr>
                </table>
              </div>
            </td>
            <td class="questionCell">Please enter the id on the barcode for the bacteria field test
              <p class="relevance">Question relevant when: selected( ${testing_consent_given} , 'yes')</p>
            </td>
            <td class="answerCell response-note-cell"/>
          </tr>
          <tr class="gray entryRow">
            <td style="height: 100%;">
              <div style="height: 100%; width: 100%">
                <table class="table borderless" style="height: 100%">
                  <tr>
                    <td class="spacer" style="background-color: #707070;"/>
                    <td class="fieldCell" style="padding-left: 5px;">
                      <span>ws_bac_test_id_check
                        <span class="required">(required)</span>
                      </span>
                    </td>
                  </tr>
                </table>
              </div>
            </td>
            <td class="questionCell">The barcode you entered manually does not match the barcode you scanned. Please go back and try again, or replace the barcode. 
              <br/>The barcode you entered manually was [ws_bac_test_id_manual]. 
              <br/>The barcode you scanned was [ws_bac_test_id].
              <br/>
              <p class="relevance">Question relevant when: ( ${ws_bac_test_id_manual} != ${ws_bac_test_id} ) and selected( ${testing_consent_given} , 'yes')</p>
            </td>
            <td class="answerCell response-note-cell"/>
          </tr>
          <tr class="entryRow">
            <td style="height: 100%;">
              <div style="height: 100%; width: 100%">
                <table class="table borderless" style="height: 100%">
                  <tr>
                    <td class="spacer" style="background-color: #707070;"/>
                    <td class="fieldCell" style="padding-left: 5px;">
                      <span>arsenic_test_result
                        <span class="required">(required)</span>
                      </span>
                    </td>
                  </tr>
                </table>
              </div>
            </td>
            <td class="questionCell">Please enter the test result for the arsenic field test.
              <p class="relevance">Question relevant when: selected( ${testing_consent_given} , 'yes')</p>
            </td>
            <td>
              <table class="table table-bordered table-condensed">
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">0</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>0</span>
                  </td>
                </tr>
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">10</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>10</span>
                  </td>
                </tr>
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">25</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>25</span>
                  </td>
                </tr>
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">50</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>50</span>
                  </td>
                </tr>
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">100</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>100</span>
                  </td>
                </tr>
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">250</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>250</span>
                  </td>
                </tr>
                <tr>
                  <td class="response-note-cell"></td>
                  <td style="text-align: center; padding-left: 3px; padding-right: 3px;">500</td>
                  <td style="width: 100%; padding-left: 3px; padding-right: 3px;">
                    <span>500</span>
                  </td>
                </tr>
              </table>
            </td>
          </tr>
          <tr class="gray entryRow">
            <td style="height: 100%;">
              <div style="height: 100%; width: 100%">
                <table class="table borderless" style="height: 100%">
                  <tr>
                    <td class="spacer" style="background-color: #707070;"/>
                    <td class="fieldCell" style="padding-left: 5px;">
                      <span>arsenic_test_results_note</span>
                    </td>
                  </tr>
                </table>
              </div>
            </td>
            <td class="questionCell">Please show the respondent the result of the arsenic field test.
              <br/>Inform the respondent that the test says that the water sample is contaminated according to the Bangladeshi standard (higher than 50).
              <br/>
              <p class="relevance">Question relevant when: not(selected( ${arsenic_test_result} , '0')) and not(selected( ${arsenic_test_result} , '10')) and not(selected( ${arsenic_test_result} , '25'))</p>
            </td>
            <td class="answerCell response-note-cell"/>
          </tr>
          <tr class="entryRow">
            <td style="height: 100%;">
              <div style="height: 100%; width: 100%">
                <table class="table borderless" style="height: 100%">
                  <tr>
                    <td class="spacer" style="background-color: #707070;"/>
                    <td class="fieldCell" style="padding-left: 5px;">
                      <span>arsenic_test_results_note2</span>
                    </td>
                  </tr>
                </table>
              </div>
            </td>
            <td class="questionCell">Please show the respondent the result of the arsenic field test.
              <br/>Inform the respondent that the test says that the water you tested has an arsenic level lower than 50, the Bangladeshi standard to define the level of contamination.
              <br/>
              <p class="relevance">Question relevant when: selected( ${arsenic_test_result} , '0') or selected( ${arsenic_test_result} , '10') or selected( ${arsenic_test_result} , '25')</p>
            </td>
            <td class="answerCell response-note-cell"/>
          </tr>
          <tr class="gray entryRow">
            <td style="height: 100%;">
              <div style="height: 100%; width: 100%">
                <table class="table borderless" style="height: 100%">
                  <tr>
                    <td class="spacer" style="background-color: #707070;"/>
                    <td class="fieldCell" style="padding-left: 5px;">
                      <span>ws_test_results</span>
                    </td>
                  </tr>
                </table>
              </div>
            </td>
            <td class="questionCell">Please give the respondent the report card for the arsenic field test, and inform them that the results for the bacterial test will take 1 or 2 days to be ready, and that the results will be sent as an sms.
              <p class="relevance">Question relevant when: selected( ${testing_consent_given} , 'yes')</p>
            </td>
            <td class="answerCell response-note-cell"/>
          </tr>
        </tbody>
      </table>
    </div>
  </body>
</html>
